Generally, case reports are written about the cases of uncommon diseases or syndromes. After Solomon and Cappa's case report published in 1987, it took 10 more years for Andersen and Bovim to report that ED due to cycling is not uncommon. The study was questionnaire based cross sectional study among Norwegian annual bicycle touring race of 540km. Among responded 160 male participants, 35(22%) reported symptoms from the innervation area of the pudendal or cavernous nerves. Impotence was reported by 21 (13%) of the males.(Andersen and Bovim Acta Neurol Scand. 1997 Apr;95(4):233-40. Impotence and nerve entrapment in long distance amateur cyclists)

In 2001, Sommer and colleagues reported that cycling with upright position decrease the penile oxygen level significantly compare to standing or reclining position and concluded that there is a deficiency in penile perfusion caused by perineal arterial compression. And also indicated that longer distance cycling such as more than 400km per week is a risk factor of ED.

In 2002 two groups demonstrated that the shape of saddle affects significantly on penile blood flow and especially existence of saddle nose affect on decreasing penile perfusion. And one of the groups made a study to compare the decrease of oxygen level of penile blood flow using four types of saddles.

The first case of ED possibly affected by cycling reported in 1987. And by the time of 2002 three key features were known, this phenomenon was commonly observed among male cyclists, sitting on saddles compresses perineal area and obstructs blood flow, the shape of saddles is one of the key factors.